Body Representation in Anorexia Nervosa
Anorexia nervosa (AN) is an eating disorder that mainly affects young women. One of the most striking symptoms of this disorder is the distorted experience of body size and shape. Patients are by definition underweight, but experience and perceive their body as bigger than it in reality is. This body representation disturbance has fascinated scientists for many decades, leading to a rich and diverse body of literature on this topic. Research shows that AN patients do not only think that their body is bigger than reality, and visually perceive it as such, but that other sensory modalities also play an important role in oversized body experiences. Patients for example have an altered (enlarged) size perception of tactile stimuli, and move their body as if it is larger than it actually is. Moreover, patients with AN appear to process and integrate multisensory information differently than healthy individuals, especially in relation to body size. This leads to the conclusion that the representation of the size of the body in the brain is enlarged. This conclusion has important implications for the treatment of body representation disturbances in AN. Traditionally treatment of AN is very cognitive in nature, it is possible however that changed cognitions with respect to body size experiences do not lead to actual changes in metric representations of body size stored in the brain. Recently a few studies have been published in which a multisensory approach in treatment of body representation disturbance in AN has been found to be effective in treating this symptom of AN.